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Pregnancy termination following prenatal diagnosis of anencephaly or spina bifida: a systematic review of the literature.

Publication ,  Journal Article
Johnson, CY; Honein, MA; Dana Flanders, W; Howards, PP; Oakley, GP; Rasmussen, SA
Published in: Birth Defects Res A Clin Mol Teratol
November 2012

BACKGROUND: In regions where prenatal screening for anencephaly and spina bifida is widespread, many cases of these defects are diagnosed prenatally. The purpose of this study was to estimate the frequency of termination of pregnancy (TOP) following prenatal diagnosis of anencephaly or spina bifida and to investigate factors associated with TOP that might lead to selection bias in epidemiologic studies. METHODS: We included articles indexed in Medline or Embase between 1990 and May 2012 reporting the frequency of TOP following prenatal diagnosis of anencephaly or spina bifida with English-language abstracts, 20 or more prenatally diagnosed cases, and at least half of the study years in 1990 or later. We summarized the frequency of TOP across studies using random-effects metaanalysis and stratified results by fetal and study characteristics. RESULTS: Among the 17 studies identified, 9 included anencephaly and 15 included spina bifida. Nine were from Europe, six were from North America, and one each was from South America and Asia. The overall frequency of TOP following prenatal diagnosis was 83% for anencephaly (range, 59-100%) and 63% for spina bifida (range, 31-97%). There were insufficient data to stratify the results for anencephaly; TOP for spina bifida was more common when the prenatal diagnosis occurred at less than 24 weeks' gestation, with defects of greater severity, and in Europe versus North America. CONCLUSIONS: Because underascertainment of birth defects might be more likely when the pregnancy ends in TOP and TOP is associated with fetal characteristics, selection bias is possible in epidemiologic studies of anencephaly or spina bifida.

Duke Scholars

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Published In

Birth Defects Res A Clin Mol Teratol

DOI

EISSN

1542-0760

Publication Date

November 2012

Volume

94

Issue

11

Start / End Page

857 / 863

Location

United States

Related Subject Headings

  • Spinal Dysraphism
  • Publication Bias
  • Prenatal Diagnosis
  • Pregnancy
  • Humans
  • Gestational Age
  • Genetics & Heredity
  • Female
  • Europe
  • Asia
 

Citation

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Chicago
ICMJE
MLA
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Johnson, C. Y., Honein, M. A., Dana Flanders, W., Howards, P. P., Oakley, G. P., & Rasmussen, S. A. (2012). Pregnancy termination following prenatal diagnosis of anencephaly or spina bifida: a systematic review of the literature. Birth Defects Res A Clin Mol Teratol, 94(11), 857–863. https://doi.org/10.1002/bdra.23086
Johnson, Candice Y., Margaret A. Honein, W. Dana Flanders, Penelope P. Howards, Godfrey P. Oakley, and Sonja A. Rasmussen. “Pregnancy termination following prenatal diagnosis of anencephaly or spina bifida: a systematic review of the literature.Birth Defects Res A Clin Mol Teratol 94, no. 11 (November 2012): 857–63. https://doi.org/10.1002/bdra.23086.
Johnson CY, Honein MA, Dana Flanders W, Howards PP, Oakley GP, Rasmussen SA. Pregnancy termination following prenatal diagnosis of anencephaly or spina bifida: a systematic review of the literature. Birth Defects Res A Clin Mol Teratol. 2012 Nov;94(11):857–63.
Johnson, Candice Y., et al. “Pregnancy termination following prenatal diagnosis of anencephaly or spina bifida: a systematic review of the literature.Birth Defects Res A Clin Mol Teratol, vol. 94, no. 11, Nov. 2012, pp. 857–63. Pubmed, doi:10.1002/bdra.23086.
Johnson CY, Honein MA, Dana Flanders W, Howards PP, Oakley GP, Rasmussen SA. Pregnancy termination following prenatal diagnosis of anencephaly or spina bifida: a systematic review of the literature. Birth Defects Res A Clin Mol Teratol. 2012 Nov;94(11):857–863.
Journal cover image

Published In

Birth Defects Res A Clin Mol Teratol

DOI

EISSN

1542-0760

Publication Date

November 2012

Volume

94

Issue

11

Start / End Page

857 / 863

Location

United States

Related Subject Headings

  • Spinal Dysraphism
  • Publication Bias
  • Prenatal Diagnosis
  • Pregnancy
  • Humans
  • Gestational Age
  • Genetics & Heredity
  • Female
  • Europe
  • Asia